by Margaret MacDonald

Maternal mortality was once described as the neglected tragedy of global health. Though it was estimated in the 1980s that nearly half a million women died each year from pregnancy and birth related causes – 99% of them in the global south – little attention was paid and little progress was made for many years. Recently, however, the problem of maternal mortality has become somewhat of a cause célèbre attracting the attention of world leaders, billionaire philanthropists, celebrity journalists, and filmmakers. Former supermodel Christy Turlington, for example, made a documentary film about maternal mortality in 2010 and launched her own NGO, Every Mother Counts. Melinda Gates has become a key advocate and donor, gracing the podium of most significant global meetings on the topic. Canadian Prime Minister Stephen Harper, for his part, has made global maternal and child health his legacy issue, launching the Muskoka Initiatives I and II which garnered billions of dollars in funding commitments from G8 and G20 nations, and holding an international summit in Toronto in 2014.

As the global campaign to reduce maternal mortality has been scaled up, so has its ‘image world’ (Sontag 1977) in order to meet the expectations of this new era of high profile humanitarianism.  In this brief blog post I share a few insights about this image world from my anthropological research, starting with the photo below.

Schoolgirl WD foyer 2013
Photo by Margaret MacDonald

I took this photo at the Women Deliver conference in Kuala Lumpur in May 2013. (Women Deliver is perhaps the most influential women’s health advocacy organization in the world). It is one of a series by American photographer Mark Tuschman, commissioned especially for display at the conference. This photo and the others in Tuschman’s series speak to the viewer of a social injustice overcome or medical disaster averted: the teenage girl in the photo is still in school; a nurse talks to a pregnant woman in a functioning health facility; a smiling new mother holds her healthy baby. Though scholars have long debated the power of images of ‘suffering others’ to foment amongst viewers a sense of shared humanity that can move them to awareness and action, what I have found in my research is a new visual economy of hope and aspiration. As the Communications Director of a US global health NGO explained to me:

My view is that it’s just as simple as images make connections for people on different part of the planet…We don’t take the approach through the images of trying to shock people. We tend to try to select more positive images. It really just comes down to this very simple factor of, Is there something in this that will connect for people? … We tend to just pick young women who are engaged with the camera. Or mothers and babies. Or a young couple and a baby…And then it just comes down to, Are we trying to send a message of despair or hope?

In another interview for this research, I was directed to a photograph that my interviewee called ‘iconic’ in the global maternal health community.

30 August 2011, Rajasthan,India: Local girls meeting Mabel van Oranje on a tour of rural Rajasthan, India at Bonli and Hanuta villages meeting with local leaders and village girls to discuss the issue of child marriage. Picture by Graham Crouch/The Elders
30 August 2011, Rajasthan,India: Local girls meeting Mabel van Oranje on a tour of rural Rajasthan, India at Bonli and Hanuta villages meeting with local leaders and village girls to discuss the issue of child marriage. Picture by Graham Crouch/The Elders

In this photo the new poster child for reducing maternal mortality across the globe is literally a child – not a newborn, not a young mother, but an adolescent girl, who, if we succeed in our aspirations for her, will stay in school, get access to information about her reproductive and sexual health, not marry while in her teens, have access to and use contraceptives in her marriage, plan her pregnancies, give birth in a proper health facility, and experience a level of economic and social equality much greater than her mother’s generation. The infrequent images of maternal suffering that do exist in this image world tend to be structured by the same narrative: I’m thinking of a photo I saw in 2012 during the UN General Assembly in New York at a side event showcasing the work of maternal health projects. The image was of an exhausted woman on a blood stained hospital bed with her newborn swaddled neatly beside her. At first you notice the grim surroundings, the evidence of poverty and cultural difference. But then you see that the woman and her baby are sharing the frame with the biomedical equipment and packages of brand name drugs that you are to assume just saved her life.

My key point is that such images in maternal health campaigns are not ancillary to interventions; though easier to look at than image of ‘suffering others’, they are not just for show. The visual economy of hope and aspiration in the image world of maternal is part of “rendering technical” the problem of maternal mortality (Li 2007) and offering up solutions. The technical problem in this case is gender and the solution is girls’ education and empowerment. In this way the image world of maternal mortality is a biopolitical project working through the body, cultivating new norms and desires for its care, its conduct, its consumption habits, its modes of giving birth. The visual message neatly reflects the policy shift in global maternal health in recent years from a focus on ensuring safe prenatal and maternity care for women everywhere toward the much broader goal of women’s sexual and reproductive rights. The appeal of such a message to a mainstream western viewing public is obvious; aspiring others and carefully reproducing mothers positioned as those who will make the world go round are people we can get behind.

Margaret MacDonald (maggie@yorku.ca) is an Assistant Professor in the Department of Anthropology at York University in Toronto, Canada.

Works cited

Li, Tania 2007. The Will to Improve.

Susan Sontag. 1973. On Photography. NY: Farrar, Strauss and Giroux

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